How many is too many?

So I said on one of my other posts that I would revisit the following topics in random thoughts (a great category if ever there was one, I think you’ll agree), and they’re all kind of about how many, or how much… because it’s something I wondered about and I found it quite difficult to find the information online before I was in the position to ask the hospital about it.

1) How many IVF cycles do you get?

Unfortunately, this is something that it’s really hard to get up to date information on. Or at least, it was for me. If you’re in the UK, your local Clinical Commissioning Group (CCG) decides how many cycles you get, and even then you need to be eligible for IVF. NICE (National Institute for Health and Care Excellence) recommends 1 to 3 cycles of IVF for eligible women aged 23-39 who meet the eligibility criteria. There is more information here but basically you need to have been trying for 2 years and be diagnosed with fertility problems. If you’re 40 or over, have other children, or smoke then you may also have difficulty getting funding – it varies by CCG and the NICE guidelines aren’t mandatory. Fortunately in our CCG in London, we are eligible for 3 cycles on the NHS, which sounds pretty amazing. We are hugely relieved because private IVF costs anything from £5k upwards and we don’t have anything like that. There’s an interesting article on the postcode lottery that explains some of the complications. Ultimately, I’d say ask your doctor.

2) Are you freezing?

Not referring to the normal British weather, but what happens to the eggs/embryos that aren’t used? It’s really not a question you think about very often, because an egg released during a normal cycle just gets lost naturally. There’s a wodge of consent forms you have to fill in at the kickoff – and you have to decide whether you are happy for your potential babies to be frozen, and if so, how long for. The default is 10 years. And if you don’t use them, can you consent to them being used for research? For me it was a no brainer… even though I’m “kind of pro life” (in a non violent way), I want to support research because maybe that means that one day people in our position will have an easier way to deal with things.

It also means that if you have to go through subsequent cycles, you can use frozen embryos and it’s much less invasive – and less costly. In our hospital it does impact the success rates – from the late 30%s to around 25%, but that might be worth it if you react badly to the egg harvesting process. (There’s something called OHSS – overian hyperstimulation syndrome, where too many eggs develop as a result of the IVF process – or other complications which mean you might not want to go through egg harvesting again any time soon.) But then ethically… You might have twins born several years apart. Or if you’re letting them be used for research, what are you actually doing to your potential babies? It’s an ethical can of worms and I’m not even there yet. I don’t know if I’ll even manage to get any eggs. I hope I can… It’s so much to think about and I think I’ll think about it when and if it happens.

3) One, two, three…

Believe it or not – you have to decide when they’re implanting the embryos, whether you’re going for one, two, or even three. This is partly dependent on the quality of your fertilised eggs – you may not even get one, so the decision will be moot. But we did have to think about it, because often people go for two to increase the chances of one “taking”. I was all for having twins (and already making up their names in my head, a boy and a girl) but T was more hesitant. I guess I just think, I want to try and give B Baby the biggest chance of being. I would love to go through all this just once. I like the idea of getting it done in one go! (Triplets is maybe a step too far though…!)